Biomedical subjects

J C Anthony

Publications and source records attributed to J C Anthony.

At least 73 records · Page 4Linked to original sources

PubMed1998

Clusters of marijuana use in the United States.

In this study, the authors test for and estimate the clustering of marijuana use within United States neighborhoods, making use of data from annual nationally representative household sample surveys conducted during the period 1990-1995. A recently developed statistical method, alternating logistic regression, was used to quantify the clustering of marijuana users in neighborhoods. The resulting estimates of pairwise odds ratios ranged from 1.3 (95% confidence interval 1.22-1.42) for the lifetime history of marijuana use to 2.0 (95% confidence interval 1.6-2.6) for recent sharing of marijuana from one person to another. Exploratory analysis showed a slight decrease of clustering effects after adjustment for individual-level covariates: age, sex, race, education, annual family income, and history of tobacco use. Nevertheless, the main factors that account for clustering remain to be determined. Alternating logistic regression provided useful estimates of marijuana use clustering and can be used to estimate clustering of the other drug-related behavior, including sharing of needle injection equipment and other human immunodeficiency virus risk behaviors. As a form of multilevel analysis, the alternating logistic regression can accommodate shared, community-level characteristics that might influence drug taking (e.g., collective efficacy), as well as individual-level covariates, such as age and sex.

Adolescent↗

PubMed1998

The epidemiology of adolescent inhalant drug involvement.

OBJECTIVE: To fill some of the gaps in our knowledge of the epidemiology of inhalant drug use. We examine age, sex, and race or ethnicity variations in the occurrence of inhalant use as well as time trends and the purported transitory nature of inhalant use among adolescents in the United States. DESIGN: The data analyzed in this report were collected as part of the National Household Survey on Drug Abuse from 1990 through 1995. This annual survey is designed to provide cross-sectional information about the patterns of drug use among nationally representative samples of US household residents aged 12 years and older. PARTICIPANTS: The sample included 34826 adolescents aged 12 to 17 years who participated in the National Household Survey on Drug Abuse from 1990 through 1995 (N=2177-8005 per survey year). RESULTS: The use of inhalants, particularly aerosols and glue, increased during the first half of the current decade. Initiation of inhalant use is not limited to early adolescence and is not a transitory behavior among adolescents in the United States. The use of inhalants is equally common among members of both sexes, and non-Hispanic white youths are more likely to report use than are members of other race or ethnic groups. CONCLUSIONS: The increasing use of inhalants, their widespread availability, and the risks involved with their use indicate a need for more focused attention on this public health problem.

Adolescent↗

PubMed1998

Availability of eIF4E regulates skeletal muscle protein synthesis during recovery from exercise.

We examined the association of the mRNA cap binding protein eIF4E with the translational inhibitor 4E-BP1 in the acute modulation of skeletal muscle protein synthesis during recovery from exercise. Fasting male rats were run on a treadmill for 2 h at 26 m/min and were realimented immediately after exercise with either saline, a carbohydrate-only meal, or a nutritionally complete meal (54.5% carbohydrate, 14% protein, and 31.5% fat). Exercised animals and nonexercised controls were studied 1 h postexercise. Muscle protein synthesis decreased 26% after exercise and was associated with a fourfold increase in the amount of eIF4E present in the inactive eIF4E.4E-BP1 complex and a concomitant 71% decrease in the association of eIF4E with eIF4G. Refeeding the complete meal, but not the carbohydrate meal, increased muscle protein synthesis equal to controls, despite similar plasma concentrations of insulin. Additionally, eIF4E.4E-BP1 association was inversely related and eIF4E.eIF4G association was positively correlated to muscle protein synthesis. This study demonstrates that recovery of muscle protein synthesis after exercise is related to the availability of eIF4E for 48S ribosomal complex formation, and postexercise meal composition influences recovery via modulation of translation initiation.

Animal Nutritional Physiological Phenomena↗

PubMed1998

Onset and recovery from panic disorder in the Baltimore Epidemiologic Catchment Area follow-up.

BACKGROUND: The objective is to estimate parameters of the natural history of panic disorder, including its prodrome, incidence, recovery and recurrence. METHOD: In 1981 the Baltimore Epidemiologic Catchment Area Study interviewed 3481 individuals probabilistically selected from the household population. During 1993-1996, 1920 of these individuals (73% of survivors) were interviewed again. Baseline and follow-up interviews included the National Institute of Mental Health Diagnostic Interview Schedule. During the follow-up, a subsample was assessed by psychiatrists using the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: There were 35 new cases of panic disorder in 24,475 person years of exposure, yielding an annual incidence of 1.43 per 1000 per year. Data from the SCAN assessments suggest the incidence estimate is conservative. Incidence is greater in females and declines with age. About one-third of the new cases arise without agoraphobia, but about half have anxiety of some sort present for many years prior to meeting criteria for diagnosis. People with agoraphobia have less intense onsets but slower recoveries than those without agoraphobia. CONCLUSIONS: Panic is heterogeneous in its pattern of onset and recovery. Some of the heterogeneity is associated with the presence of other anxiety over a long period of the life.

Adolescent↗

PubMed1998

Personal characteristics associated with injecting drug use among Latinas in the United States of America.

This study examines nonmedical injecting drug use (IDU) among Latinas aged 12 years and older in a nationally representative sample of U.S. households. Data from the 1990-1995 National Household Surveys on Drug Abuse disclosed 154 Latinas with self-reported histories of IDU out of 18,335 Latinas who responded. Hypotheses about correlates of IDU were tested by using the conditional form of multiple logistic regression to compare the characteristics of these IDUs with those of 602 noninjecting Latinas matched on neighborhood of residence. In the USA, an estimated 1% of Latinas age 12 years and older have injected drugs for nonmedical purposes on at least one occasion. IDU was 4.6 to 6.5 times greater for adult Latinas (18-44 years old) when compared to Latinas aged either 12 through 17 years (P < 0.05) or older than 44 years. IDU was an estimated 7.1 times greater for Latinas who reported marijuana use and 5.4 times greater for Latinas who reported inhalant use when compared to Latinas not using these drugs (P < 0.01). In light of recent studies indicating that IDU is a serious public health problem for Latinas in the United States, the observed associations represent first steps in an effort to understand the Latina subgroups most affected by IDU and the underlying risk factors or causes of this behavior.

Adolescent↗

PubMed1998

Targeting early antecedents to prevent tobacco smoking: findings from an epidemiologically based randomized field trial.

OBJECTIVES: This study examined whether interventions aimed at aggressive/disruptive classroom behavior and poor academic achievement would reduce the incidence of initiation of smoking. METHODS: An epidemiologically based, universal randomized preventive trial involved 2311 children in 2 classroom-based preventive interventions or controls. Each intervention was directed at 1 of the aforementioned 2 antecedents over first and second grades in 19 urban schools. RESULTS: Smoking initiation was reduced in both cohorts for boys assigned to the behavioral intervention. CONCLUSIONS: Targeting early risk antecedents such as aggressive behavior appears to be an important smoking prevention strategy.

Adolescent↗

PubMed1998

Use of the inhalant lança by Brazilian medical students.

In a recent epidemiological survey of more than 700 Brazilian medical students, we found new evidence on a previously reported pattern of the "lança perfume" inhalant drug use. With multiple logistic regression used to hold constant an array of suspected correlates, we found a moderately strong association between the use of marijuana and the use of lança (adjusted odds ratio, OR = 5.6; p < .01). We also found that lança is almost never used by students who have never consumed alcoholic beverages. This pattern of associations can be used to guide the planning of programs to reduce the occurrence of illicit use of pharmaceutical compounds by medical students in Brazil.

Administration, Inhalation↗

PubMed1997

The inner city and drug use: initial findings from an epidemiological study.

Although scientific and policy statements regarding drugs often suggest that there are grave problems of drug use within America's inner cities, the evidence that supports these statements is often based on anecdotal or incomplete data. This study of African-American adults from the Woodlawn study followed longitudinally partially fills that gap, at least for learning more about those who spend some or all of their childhood within an inner city neighborhood. We found few differences between the lifetime prevalence of drug use and a national representative sample of adults of the same age range. Furthermore, a national household survey of African-Americans of similar age living in six central cities also reported low lifetime rates of illicit drug use. Nevertheless, those from the Woodlawn cohort had higher rates of use of illicit drugs in the past year than the national sample, especially those still living in areas with high rates of poverty. Additionally, reports of heavy drug trafficking were much greater in the inner city areas than in the suburbs.

Adult↗

PubMed1997

Childhood misbehavior and the risk of injecting drug use.

This investigation examined the association between misbehavior in early life and subsequent injecting drug use (IDU) among Baltimore participants in the NIMH Epidemiologic Catchment Area study. Information about early misbehavior was collected in 1981 and about IDU in 1994-1996. Conditional logistic regression models were used to estimate the degree of association between early misbehavior and IDU, with injecting drug users (n = 38) and controls matched on census tract of residence (n = 745), selected from within the same community survey sample, and assessed in a methodologically identical manner. Early misbehavior was associated with subsequent IDU, independent of the associations with sex, age, and race. The estimated risk of IDU increased with the number of reported conduct problems. Early misbehavior also discriminated between injecting drug users and non-injecting drug users. These results, which support and extend earlier findings, have public health implications for preventing and stopping the risk-laden practice of injecting drug use.

Adolescent↗

PubMed1997

Discarded needles do not increase soon after the opening of a needle exchange program.

This study examines the effect of a Needle Exchange Program (NEP) on the quantity and geographic distribution of discarded needles on the streets of Baltimore, Maryland, and presents methods to survey discarded needles in the community. A random sample of 32 city blocks located within high-drug-use census tracts, stratified by east and west sides of the city and by proximity to the NEP, was selected for survey. Three teams surveyed the number of needles and the number of drug vials and unbroken glass bottles ("trash") to control for practice effects. Surveillance was conducted prior to initiation of the NEP in August 1994 and 1 and 2 months thereafter. Over the three study periods, the absolute count of discarded needles was 106, 130, and 128, respectively; the number of vials and bottles was 3,048, 3,825, and 3,796, respectively. The initial nonstatistically significant increase in needles (mean change = 0.38, 95% confidence interval (CI) -0.18 to 0.93) was offset by accounting for background trash. Regression models fitted with the generalized estimating equation method, which accounted for within-block correlation over time, showed no significant increase in the number of needles after adjustment for trash during the first 2 months of the NEP's operation. These data suggest that the initiation of NEPs does not result in an increase in the number of discarded needles on the street.

Baltimore↗

PubMed1997

Fears and other suspected risk factors for carrying lethal weapons among urban youths of middle-school age.

OBJECTIVE: To estimate the strength of a suspected causal association between fearfulness and carrying a lethal weapon among urban middle-school students, while holding constant other suspected risk factors. DESIGN: A prospective study of an epidemiological sample assessed at baseline in 1992 and 1 year later, with relative risk estimates derived from the conditional form of the multiple logistic regression model used to hold constant alternative explanatory variables. SETTING: An urban environment in the mid-Atlantic region of the United States. PARTICIPANTS: An epidemiological sample of 1131 youths enrolled in public middle schools. MAIN OUTCOME MEASURES: Carrying a lethal weapon for protection or defense during a 1-year observation interval after the baseline assessment of fears and other suspected risk factors. RESULTS: Of the 1131 youths, 194 (17%) reported carrying a lethal weapon for protection or defense during the 1-year interval of follow-up observation after baseline; 937 youths (83%) reported that they had not carried a lethal weapon for any reason. Self-reported fears, deviant peer affiliation, and worrying were associated with risk of starting to carry a weapon. For youths with the lowest worrying scores, the lowest neighborhood danger scores, and the least affiliation with deviant peers, self-reported fears were associated with risk of starting to carry a lethal weapon (relative risk estimate, 1.68; 95% confidence interval, 1.11-2.52; P = .01), even after holding constant age, sex, and conduct problems. However, the fear of crowded or closed-in places and the fear of leaving home alone were more salient risk factors than the fear of using public transportation or the fear of open spaces. CONCLUSIONS: In this study, youths with fears were at greater risk of carrying a lethal weapon for protection or defense, even when alternative explanatory variables were taken into account. Pending confirmation by other investigators, this new finding could point out a useful target for public health interventions to reduce the carrying of weapons and associated violence in urban America.

Adolescent↗

PubMed1997

Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey.

OBJECTIVE: To study patterns of co-occurrence of lifetime DSM-III-R alcohol disorders in a household sample. METHODS: Data came from the National Comorbidity Survey (NCS), a nationally representative household survey. Diagnoses were based on a modified version of the Composite International Diagnostic Interview. RESULTS: Respondents with lifetime NCS/DSM-III-R alcohol abuse or dependence had a high probability of carrying at least 1 other lifetime NCS/DSM-III-R diagnosis. Retrospective reports have suggested that most lifetime co-occurring alcohol disorders begin at a later age than at least 1 other NCS/DSM-III-R disorder. Earlier disorders are generally stronger predictors of alcohol dependence than alcohol abuse and stronger among women than men. Lifetime co-occurrence is positively, but weakly, associated with the persistence of alcohol abuse among men and of alcohol dependence among both men and women. CONCLUSIONS: Caution is needed in interpreting the results due to the fact that diagnoses were made by nonclinicians and results are based on retrospective reports of the age at onset. Within the context of these limitations, though, these results show that alcohol abuse and dependence are often associated with other lifetime DSM-III-R disorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary. Prospective data and data based on clinically confirmed diagnoses are needed to verify these findings.

Age of Onset↗

PubMed1997

Natural history of Diagnostic Interview Schedule/DSM-IV major depression. The Baltimore Epidemiologic Catchment Area follow-up.

BACKGROUND: Natural history can be characterized by incidence, recurrence, and duration of episodes. Research on the incidence of major depression is rare; studies of recurrence and duration are limited to clinical samples. METHODS: The Baltimore, Md, site of the Epidemiologic Catchment Area Program followed up its 1981 baseline cohort of 3481 respondents with an additional assessment in 1993 to 1996. Interviews were obtained from 1920 respondents (73% of the survivors). The Diagnostic Interview Schedule and the same survey procedures as in 1981 were used, augmented with a Life Chart Interview for dating the onset and duration of syndromes. RESULTS: There were 71 new cases of Diagnostic interview Schedule/DSM-IV major depression and 23,698 person-years of exposure, generating an estimated incidence of 3.0 per 1000 per year. Incidence peaked while subjects were in their 30s, with a smaller peak when they were in their 50s. Prodromal symptoms often occurred many years before the full criteria for diagnosis were met. Women were at higher risk for becoming new cases but had neither higher risk for recurrence nor longer episodes than men. Episodes of depression lasted for 12 weeks. The duration of an episode, and time to an episode-free year, was longer in the first episode than in recurrent episodes. CONCLUSIONS: The incidence estimated in this study is consistent with that found in the few other similar studies performed. The bimodality of onset suggests the value of further exploring the heterogeneity of depression via its natural history. Reported differences in prevalence between men and women seem to be due to differences in incidence, not chronicity.

Adolescent↗

PubMed1997

Initial opportunity to use marijuana and the transition to first use: United States, 1979-1994.

A renewed American interest in marijuana has coincided with our research group's focus on the earliest stages of drug involvement. Here, we have studied the transition from an initial opportunity to try marijuana to the subsequent use of this drug. We analyzed self-report interview data gathered from nationally representative samples of the United States National Household Surveys on Drug Abuse, 1979-1994. The evidence indicates that the estimated prevalence of an opportunity to try marijuana has been rather stable for 15 years. However, there are recent increases in the probability of rapidly progressing from first marijuana opportunity to first marijuana use, among persons given an opportunity to use. In addition, the transition from first marijuana opportunity to eventual marijuana use seems to depend upon age at first opportunity. This epidemiological evidence on the transition from marijuana opportunity to marijuana use, the first to be published based on a nationally representative US sample, highlights directions for future research and a focus for prevention efforts.

Adolescent↗

PubMed1997

The influence of drug use patterns on the rate of CD4+ lymphocyte decline among HIV-1-infected injecting drug users.

OBJECTIVES: To assess the relationship between various injecting drug use patterns and the rate of CD4+ lymphocyte decline in HIV-1-infected injecting drug users in Baltimore, Maryland, USA. METHODS: A cohort of 605 HIV-1-infected injecting drug users was recruited between 1988 and early 1989 in East Baltimore using extensive community outreach techniques. The participants were interviewed semi-annually to collect information on drug use practices. The outcome measure of interest was the rate of CD4+ lymphocyte decline between pairs of CD4+ lymphocyte counts. A mixed model was used to evaluate the relationship between the change in CD4+ lymphocyte count per month and previous CD4+ lymphocyte count and various drug use variables. RESULTS: The 605 HIV-infected injecting drug users had a median initial CD4+ lymphocyte count of 513 cells x 10(6)/l. Using 3209 paired observations, the mean change in CD4+ lymphocyte count was -3.2 cells x 10(6)/l per month. The rate of decline was higher in those with a higher level of CD4+ lymphocytes (P < 0.01) and length of drug use (P < 0.01), but did not vary by injection frequency or injection intensity of specific drug types. Although animal studies have suggested that the pattern of drug administration (continuous versus intermittent) and episodes of withdrawal or overdose might impact the rate of CD4+ lymphocyte decline, this was not observed in the present study. CONCLUSION: Patterns of injecting drug use, based on self-report, were not associated with the rate of decline in CD4+ lymphocytes.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Depression without sadness: functional outcomes of nondysphoric depression in later life.

OBJECTIVES: We hypothesized that depressive symptoms not meeting full standard criteria for Major Depression would be associated with significant functional impairment among older adults over the course of a 13-year follow-up interval. Specifically, we developed criteria for a form of depression whose core symptoms did not include sadness or dysphoria. DESIGN: Population-based 13-year follow-up survey. SETTING: Community-dwelling adults living in East Baltimore in 1981. PARTICIPANTS: Subjects were the 1612 participants of the Baltimore sample of the Epidemiologic Catchment Area Program aged 50 years and older at the initial interview in 1981. MEASUREMENTS: The subjects were sorted into four categories based on their responses at baseline: (1) persons meeting standard criteria for Major Depression; (2) persons meeting alternative criteria for depression with dysphoria or (3) without dysphoria; and (4) a comparison category of persons not meeting any criteria for depression ("noncases"). The mortality and functional status of each group were compared after a 13-year follow-up interval. RESULTS: Compared with non-cases, participants aged 50 years and older who reported depressive symptoms but who denied sadness or dysphoria (nondysphoric depression) were at increased risk for death (relative risk (RR) = 1.70; 95% confidence interval (CI) (1.09, 2.67)), impairment in activities of daily living (RR = 3.76; 95% CI (1.73, 8.14)), impairment in instrumental activities of daily living (RR = 5.07; 95% CI (2.24, 11.44)), psychologic distress (RR = 3.68; 95% CI (1.47, 9.21)), and cognitive impairment (RR = 3.00; 95% CI (1.31, 6.89)) after a 13-year follow-up interval. The findings were not wholly explained by potentially influential baseline characteristics such as age, education, selected comorbid medical conditions, and functional status. CONCLUSION: Among adults aged 50 years and older, nondysphoric depression may be as important as Major Depression in relation to the development of functional disability and other long-term outcomes.

Activities of Daily Living↗

PubMed1997

The influence of self-esteem on smoking among African-American school children.

This study provides some evidence, although not very strong, that self-esteem is associated with the likelihood of smoking among African-American children. In a sample of 1,256 children, those with lowest levels of self-esteem were twice as likely to have ever smoked as those with highest level of self-esteem (95% C.I. = 1.10-7.78). Girls, more so than boys, have an increased risk of smoking at the lowest level of self-esteem. Girls with the lowest level of self-esteem were 2.8 times (95% C.I. = 3.85-16.59) as likely to have smoked when compared to girls with higher self-esteem. The findings suggest preventive interventions that seek to build self-esteem may reduce the likelihood of smoking among girls, although perhaps only modestly. Further study is needed to identify potentially effective methods for reducing the likelihood of smoking among African-American boys.

Black or African American↗

PubMed1996

Neighborhood environment and opportunity to use cocaine and other drugs in late childhood and early adolescence.

We hypothesized that neighborhood disadvantage might function as a determinant of "exposure opportunity', an intermediate step on a path toward starting to use drugs illicitly. Testing this hypothesis, we analyzed self-report data gathered in 1992 by means of confidential interviews with 1416 urban-dwelling middle-school participants in a longitudinal field study. Within this epidemiologic sample, 50 youths said that someone actively had offered them a chance to take cocaine or smoke crack; tobacco had been offered to 395 youths; alcohol to 429 youths. Using multiple logistic regression to hold constant grade, sex, minority status, and peer drug use, we found a moderately potent association between neighborhood disadvantage and exposure to cocaine: youths living in the most disadvantaged neighborhoods (highest tertile) were an estimated 5.6 times more likely to have been offered cocaine, as compared to those in relatively advantaged neighborhoods (P = 0.001). By comparison, there were weaker but statistically significant associations involving tobacco exposure opportunity (odds ratio, OR = 1.7, P = 0.004) and alcohol exposure opportunity (OR = 1.9, P = 0.0005). Future research will clarify the etiologic significance of neighborhood disadvantage in pathways leading toward illicit drug use.

Adolescent↗